Flu jabs will not stop outbreak says doctor that co-created it

[tropical]

An Telegraph.co.uk news:

http://www.telegraph.co.uk/news/main.jhtml;jsessionid=OAR1LNYKSIOJVQFIQMGCFFWAVCBQUIV0?xml=/news/2007/11/24/nflu124.xml

<TABLE><TBODY><TR><TD>Flu jabs will not stop outbreak, says doctor

By Aislinn Simpson
Last Updated: 3:05am GMT 24/11/2007

<TABLE cellSpacing=0 cellPadding=0 width="100&#37;" border=0><TBODY><TR><TD>The creator of the flu jab has agreed with warnings that a major outbreak of the illness is likely and admits that his drug will do little to stop it.
Dr Graeme Laver, who helped to create the vaccine more than 40 years ago, said that although the jab could afford some protection to the 15 million Britons who receive it each year, it should not be relied on.
Dr Laver said: "If the seasonal flu is as bad as it was in Australia, you are in for a pretty bad time.
advertisement
<SCRIPT language=javascript src="/core/NetGravity/mpu.js"></SCRIPT>
"You could have a really severe epidemic. Thousands will be ill and many will die. The safe and effective anti-flu drugs could, if used correctly, avoid much of this distress."
He said drugs that fight flu once it has struck, such as Tamiflu and Relenza, should be readily available over the counter instead of by prescription as they are at present.
The Australian scientist, who receives royalties for Relenza but not for Tamiflu, said he had never been impressed with the power of his own vaccine.
"It is better than nothing and I wouldn't want to advise people not to take it," he said. "But you can't rely on it doing any good."
In a normal year, the influenza virus kills about 12,000 people in Britain, most of them elderly, and during the winter. But the flu virus periodically mutates into a new strain that is resistant to normal anti-viral drugs.
Some scientists say a flu pandemic is now overdue, either from the mutation of the normal human flu virus, or of the H5N1 strain that infects birds.
The number of flu victims in Australia tripled this year compared to last year, with those normally not affected by the disease catching it.
In just five weeks in New South Wales, 800 people died from pneumonia, which often develops from flu.
Like the UK, Australia had several winters of mild flu outbreaks which, according to experts, leaves the population more vulnerable to infection.
Meanwhile, the US Food and Drug Administration recommended that the packaging of the drugs carry warnings about psychiatric problems.
In documents prepared for a meeting to review both drugs next week, FDA staff have recommended that Tamiflu's label warn of the possibility of "serious injuries, including death, in adult and paediatric patients" brought on by delirium or self-injury.
It recommends that Relenza's label mentions "reports of hallucinations, delirium and abnormal behaviour".


</TD></TR></TBODY></TABLE><!--NO VIEW-->
Information appearing on telegraph.co.uk is the copyright of Telegraph Media Group Limited and must not be reproduced in any medium without licence. For the full copyright statement see Copyright


</TD></TR></TBODY></TABLE><!-- Start Log --><SCRIPT language=javascript>var _hbEC=0,_hbE=new Array;function _hbEvent(a,b){b=_hbE[_hbEC++]=new Object();b._N=a;b._C=0;return b;}var hbx=_hbEvent("pv");hbx.vpc="HBX0100u";hbx.gn="a.te legraph.co.uk";hbx.acct="DM550808OANC78EN3";hbx.pn def="title";hbx.ctdef="full";hbx.elf=".!telegraph. ";hbx.ci="unknown";hbx.pn="(Flu+jabs+will+not+stop +outbreak,+says+doctor)/2007/11/24/nflu124.xml";hbx.mlc="/portal/printpage/article";hbx.fv="";hbx.lt="auto";hbx.hc1="unregist ered";hbx.hc2="unknown|unknown";hbx.hc3="unknown|u nknown";hbx.hc4="/portal/printpage/article/2007/11/24/nflu124.xml|Flu+jabs+will+not+stop+outbreak,+says+ doctor";cv=_hbEvent("cv");cv.c5="/portal/printpage/article/2007/11/24/nflu124.xml|2007_11_24";cv.c6="/portal/printpage/article/2007/11/24/nflu124.xml|By+Aislinn+Simpson";cv.c7="/portal/printpage/article/2007/11/24/nflu124.xml|/news/2007/11/24/nflu124.xml";cv.c8="portal|13";cv.c9="/portal/printpage/article/2007/11/24/nflu124.xml|13";hbx.hrf="";hbx.pec="";</SCRIPT><!-- End Log --><NOSCRIPT></NOSCRIPT><SCRIPT language=javascript1.1 src="/core/hbx.js"></SCRIPT><!-- START REVENUE SCIENCE PIXELLING CODE --><SCRIPT language=JavaScript src="/core/RevSci.js"></SCRIPT><SCRIPT language=JavaScript>if (document.cookie != "" && document.cookie.indexOf("tcuk_geo=") >= 0){var str = document.cookie;str = str.substring(str.indexOf("tcuk_geo=") + 9,str.indexOf("tcuk_geo=") + 11);DM_addToLoc("Country",str);} else {DM_addToLoc("Country","XX");}DM_addToLoc("Site",e scape("Telegraph"));DM_addToLoc("Level1",escape("p ortal"));DM_addToLoc("Level2",escape("printpage")) ; DM_tag();</SCRIPT><NOSCRIPT></NOSCRIPT><SCRIPT src="http://js.revsci.net/gateway/gw.js?csid=E06560" type=text/javascript charset=ISO-8859-1></SCRIPT><SCRIPT src="http://js.revsci.net/common/pcx.js?csid=E06560&ko=2007_12_19__1" type=text/javascript charset=ISO-8859-1></SCRIPT><SCRIPT type=text/javascript>var segQS = "";var date = new Date();if (rsinetsegs.length > 0){segQS = rsinetsegs[0];for (var i = 1; i < rsinetsegs.length; i++){segQS += ("," + rsinetsegs[i]);}date.setTime(date.getTime()+(31*24*60*60*1000)) ;var expires = "expires=" + date.toGMTString();document.cookie = "tcuk_revsci=" + segQS + "; domain=telegraph.co.uk; " + expires + "; path=/";}</SCRIPT><!-- END REVENUE SCIENCE PIXELLING CODE -->

[Giuseppe]

Re: Flu jabs will not stop outbreak says doctor that co-created it

It is hard to predict the course of incoming seasonal human influenza outbreaks across European countries. To date (and see also at EISS website - European Influenza Surveillance Scheme - http://www.eiss.org), influenza A circulation in Europe in at baseline level and the large part of isolates belongs to type A/H1N1/Solomon Island-like strain, included in Northern Emisphere seasonal vaccines. Only a minority of isolates belong to A/H3N2/Brisbane lineage, that isn't included in trivalent inactivate seasonal vaccines for NE for 2007/08 Season. Other isolates belong to type B influenza. Seasonal outbreaks in Australia were recorded as moderate to severe, due in part as the emergence of the novel drift variant A/H3N2 Brisbane.
It is discouraging that an expert in virology declares that vaccination is useless at least. But I think media reports could be somewhat incorrect or re-paint with color a story already seen in the past.

[Shannon Bennett]

Re: Flu jabs will not stop outbreak says doctor that co-created it

The vaccine was two misses and one hit this winter. It will discourage some who get sick despite the jab from getting the vaccine next year. Many people do not realize the poor match in this seasons available flu vax. I wish I had a dollar for every person who told me they got the flu from getting the vaccination. The NIH needs to do a better job of actually how the process works.

[Giuseppe]

Re: Flu jabs will not stop outbreak says doctor that co-created it

The vaccine was two misses and one hit this winter. It will discourage some who get sick despite the jab from getting the vaccine next year. Many people do not realize the poor match in this seasons available flu vax. I wish I had a dollar for every person who told me they got the flu from getting the vaccination. The NIH needs to do a better job of actually how the process works.

A mismatched composition for TIV doens't mean an ineffective vaccine, since a certain number of people could have catch in the past an influenza virus similar to those circulating. During the seasonal winter influenza outbreaks in Australia, in several instances news contained some 'experts' advice about the effectiveness of TIV compared to oseltamivir. Further, another 'expert' advocated an OTC-like distribution for oseltamivir (and not for zanamivir), that would be a real disaster, after the discovery of human influenza strain with reduced sensitivity to Neuraminidase inhibitors.
Vaccination doesn't mean a complete protection against influenza but a reasonable chance to be protected or for a less intense illness. It is one of the less expensive tool for reducing morbidity in a otherwise unprotected population, with special regard to the groups with low income and no or partial health care insurance.

[hawkeye]

Re: Flu jabs will not stop outbreak says doctor that co-created it

Same with virtually everyone I've spoken to that has received it.

I wish I had a dollar for every person who told me they got the flu from getting the vaccination. The NIH needs to do a better job of actually how the process works.

[Niko]

Re: Flu jabs will not stop outbreak says doctor that co-created it

Another concern is that in our quick fix, pop-a-pill society, people will be less conscientious about their susceptibility to infection and their potential to spread communicable disease. I've cautioned an elderly relative to be extra vigilant with hand-washing, distancing, etc. only to hear.."well, I had my flu shot, so I'm not too concerned"

[tropical]

Re: Flu jabs will not stop outbreak says doctor that co-created it

"The vaccine was two misses and one hit this winter."
that
mean an ineffective vaccine for 2 strains.


I think that if his words are rightly interpretated in the news,

Dr Graeme Laver, who helped to create the vaccine more than 40 years ago,

have more rights to interpret the efectiveness of the flu vaccine, till the technology of making vaccines remains the same of 40 years ago.

[Giuseppe]

Re: Flu jabs will not stop outbreak says doctor that co-created it

Influenza vaccines are neglected drugs, but they are the only things we have ready today. More useful to advocate a widespread use in otherwise uncovered people - or not? No health insurance, low income, working-poor, ....

-
But you could also read this:

1) [AVIAN INFLUENZA, ANTIVIRALS, PANDEMIC PREPAREDNESS, UNITED KINGDOM] Pandemic flu drug order doubles


Some scientists believe a global flu pandemic could be imminent


Britain is doubling its stockpile of antiviral medicines in preparation for any future flu pandemic, health secretary Alan Johnson has announced.


This will be enough to treat about half the British population - the proportion scientists now believe could be hit by a pandemic.

Mr Johnson said the updated plan makes the country one of the most prepared in the world against pandemic flu.

Some scientists believe a global flu pandemic could be imminent.

Worse case scenario

Mr Johnson described the move as "defence in depth" based on a worst case scenario that up to 2.5% of people who fell ill with the flu would die.

He said the use of the anti-viral drug Tamiflu would be a key defence against pandemic flu in the weeks it would take to develop a vaccine against the culprit virus, but did not say what the financial cost would be.

Antivirals do not cure people of the flu but reduce the severity and length of the illness if taken early on.

Mr Johnson said they were also buying 14.7 million courses of antibiotics to help deal with the complications of flu that could lead to death.

The government also aims to buy 350 million surgical masks and 34 million respirators for frontline NHS and social care staff.

The measures are for a "reasonable worst-case scenario", which would see between 25% and 50% of the UK population infected.

Experts predict that up to 750,000 extra deaths could occur in the UK as a result of a pandemic, with up to half the population developing illness.

Mr Johnson said in the event of an outbreak, care would be home based - patients will stay at home initially to minimise the risk of spreading the infection to others.

Medicines would be collected by a "flu friend" nominated by the patient. Patients would see GPs or go into hospital if complications arose.

Graeme Laver, one of the world's leading flu experts and involved in the development of Tamiflu, said: "Instead of stockpiling more Tamiflu, the UK government would be better off devising a more effective procedure to get Tamiflu to people who fall ill very, very quickly."

Killer strain

Lethal global flu epidemics tend to occur three or four times a century.

Some scientists believe a new one may be imminent and could be triggered by bird flu.

So far there have been only a few hundred cases of the latest strain of avian flu, H5N1, recorded in humans.

But the fear is that this strain could mutate and spread quickly and easily between people, triggering a deadly pandemic.

-

http://news.bbc.co.uk/1/hi/health/7107097.stm

------

[tropical]

Re: Flu jabs will not stop outbreak says doctor that co-created it

Influenza vaccines are neglected drugs, but they are the only things we have ready today. More useful to advocate a widespread use in otherwise uncovered people - or not? No health insurance, low income, working-poor, ....

Yes, but an widespread use of an very poor strain matched vaccine means that the mases aren't protected in fact, but thinked that they are - if not very well educated, and than they will miss to obey to the "social distancing", and so, measures.

But you could also read this:
...
Mr Johnson said in the event of an outbreak, care would be home based - patients will stay at home initially to minimise the risk of spreading the infection to others.
Medicines would be collected by a "flu friend" nominated by the patient. Patients would see GPs or go into hospital if complications arose.

Very well, but the above have a problem:

If medicines means antivirals also, the only antiviral effective for now is Tamiflu - which must be taken in the first 24 hours from the onset of the infection simptomps - and those simptoms are (in the very begining) like the most respiratory illnesses simptoms - how will a non-medical population know what kind of illness is starting?

Obviously they MUST stay home to not spreading the novel virus, and than - they must have some hand held cheap fast pandemic flu tests, by which they would know if they must start to take Tamiflu.

If they must go to the doctor to receive a placet for using Tamiflu because they don't know, and they don't have a preventive 3 months course of Tamiflu, than they will spread the virus.

Graeme Laver, one of the world's leading flu experts and involved in the development of Tamiflu, said: "Instead of stockpiling more Tamiflu, the UK government would be better off devising a more effective procedure to get Tamiflu to people who fall ill very, very quickly."

I agreed with Dr Graeme Laver all but the word "instead" - it will be better to choose a policy: "along with stockpilling", it's good to stockpiling, but there is a lack of an "more effective procedure to get Tamiflu to people who fall ill very, very quickly" (24-48 hours).

[Giuseppe]

Re: Flu jabs will not stop outbreak says doctor that co-created it

I would like to fix some points:

* even a poor matched trivalent seasonal vaccine could reduce both amount of virus shed by patients and duration of illness;
* some people, having experienced already influenza in past seasons, reacted better to a poor-matched vaccine;
* in certain settings - long-term older hospices, disabled people institutions - social distancing is of difficult implementation;
* treatment with antivirals could lead to emergence of drug-resistant strains;
* seasonal influenza and pandemic influenza are distinct setting: for the seasonal influenza the aim should be to reduce morbidity and mortality among high-risk groups, for the pandemic influenza, a vaccination campaign targeted mainly HCW, essential services workers and other critical infrastructure personnel for social and administrative continuity.

[tropical]

Re: Flu jabs will not stop outbreak says doctor that co-created it

"* even a poor matched trivalent seasonal vaccine could reduce both amount of virus shed by patients and duration of illness;
* some people, having experienced already influenza in past seasons, reacted better to a poor-matched vaccine;"

That's only because we can't do better.
The technology of production is obsolete, the choosing procedure is so long, and there are no willings to waste money on vaccines.
Till when this things changes, than we can said we doing a step up to protect the citizens in 21 century.

"... for the pandemic influenza, a vaccination campaign targeted mainly HCW, essential services workers and other critical infrastructure personnel for social and administrative continuity"

One thing is what will be possible to do, another thing is what we must trying to achieve.
A policy of citizens of 1.th category "the necessary people" (the ones who got first the pand. vaccine), 2nd (the ones who maybe got the pre/pandemic vaccine), ... (the ones who will not got anything) is not good enaugh if we will have time to find new ways of mass pandemic vaccine production.

[Giuseppe]

Re: Flu jabs will not stop outbreak says doctor that co-created it

Although the threat of H5N1 is known since 1997 and an influenza pandemic is a natural phenomenon who happens regularly but in a unpredictable way, after 2001 hundreds of billions of US$ were simply wasted into bloody wars around the world (mainly by Westerns, but the developing countries spent an important part of their very poor budgets for arms), but the neglected diseases (such as influenza seasonal and pandemic) remains with only 2 or 3 billions put by WB and FMI, the main institutions involved in destruction of health care system around the world.